Houston Fertility Journal

Trying to make a baby is an emotional roller coaster. During your first two-week wait, you or your partner might spend endless hours scouring the Internet for every sign of pregnancy. You might feel exhilarated, certain that a pregnancy is just around the corner. You may also feel a touch of anxiety, as you wonder if you’ll become a parent this month, this year, or even this decade.

By month three, you might be accustomed to the wait. By month six or twelve, you might begin to worry if something is seriously wrong. As time marches on, that nagging voice in your head can give way to full scale panic. Infertility treatment can be hard on couples. Infertility touches on what makes us human, makes couples question themselves and their value to one another, and presents deep and painful existential questions. Maybe that’s why couples who face infertility are three times more likely to divorce.

Infertility treatment, however, does not have to wreck your marriage. With the right attitude, it can even bring you closer. Here’s what you need to know about why infertility treatment is so hard on couples, and what you can do to keep your relationship intact.

Endless Two-Week Waits: When You Want Something You Can’t Have

Whether you’ve been trying for six months or six years, chances are you know the agony of the two-week wait all too well. It begins when you think you might have ovulated or gotten your partner pregnant. From there, it’s an endless stream of speculation: was that twinge implantation, or a sign your period is about to start? Is that bloating an early sign of pregnancy?

For some couples, the two-week wait is a source of ceaseless excitement and hope. And every period dashes those hopes, spurring days of disappointment. For others, the two-week wait means occupying a 24/7 state of anxiety. For a few, it’s just another reminder of the failure to get pregnant. For virtually all couples, the monthly two-week wait is an emotional roller coaster that’s hard to escape.

Couples beginning infertility treatments may begin experiencing new emotions with each two-week wait. Some experience a sense of renewed hope. Others dread the next treatment, concerned that it won’t work.

The painful challenge lurking behind this wild emotional ride is the loss of control. Most couples sit down, decide when to have kids, and have them more or less in that time frame. Couples who struggle with infertility lose a sense of control over their lives, their bodies, and their family. They don’t know when or if they’ll ever have kids.

A number of feelings accompany this painful realization, including:

Resentment of couples who easily have children. “Why does he get to have a child, when I’ve tried harder, worked harder, and would be a better parent?” is a common refrain.

Self-doubt. Some couples blame themselves. “I shouldn’t have smoked. I should have lost weight. I should have had fewer sexual partners,” they say.

Depression and anxiety. Having a child is a primary biological drive. Some people worry they cannot be happy without a child. Others question their value as human beings.

Feeling hopeless and powerless.

A willingness to latch onto false promises and get-pregnant-quick schemes. When you’re desperate, even the most ridiculous promise sounds worth trying. Many infertile couples have a closet full of supplements, potions, and other failed promises.

Infertility Treatments and Your Relationship

When you feel bad, angry, hopeless, or frustrated, your relationship can suffer. Most of us turn to our partners for support. It’s normal to take some of your pain out on your partner, too.

Couples experiencing infertility often report that:

Sex is no longer about intimacy and pleasure. It’s become formulaic, and all about making a baby. The spark is gone. Some even say that sex makes them feel bad, hopeless, and like a failure.

Their entire relationship has become about making a baby. They’re no longer able to enjoy time together without discussing fertility or parenting.

The financial and emotional stress of infertility have each taken a toll on their relationship.

Saving for infertility treatments means no more vacations, fancy birthday parties, holiday gifts, or other pleasures of life.

It can be difficult to comfort your partner when you too are struggling with the pain of infertility. Perhaps this is why so many couples facing infertility drift apart. They don’t know how to comfort one another. They don’t know how to distract themselves from the desire to make a baby. No one warned them about this possibility. No one told them to plan for it. Coping with infertility is a skill that is learned on the fly, in the midst of pain. So it’s no wonder that so many couples just can’t cope.

Why Some Couples Blame Each Other

Many couples hope that they’ll turn to each other at difficult times. In the early days of infertility, that’s often the case. But as months become years and a single fertility treatment gives rise to many more, some couples turn on each other.

In some cases, the problem is that couples just don’t know how to support one another. Sometimes, though, couples blame one another -- particularly if only one partner is infertile, or if lifestyle factors are an issue.

We also sometimes see that one partner is more invested in or knowledgeable about infertility treatments. In some cases, that’s simply because different people cope with infertility in different ways. In others, one partner is more willing to keep trying, or more concerned about having children. This can present difficult financial, emotional, and logistical challenges. Couples don’t have to deal with their pain in the same way. But if there is a fundamental disagreement about how to manage infertility, infertility treatments will be more challenging -- and might not even be possible.

The Physical Challenges of Infertility Treatment

Beginning infertility treatment can give couples a sense of hope after months or years of unsuccessfully trying. What many couples don’t consider is that the treatments themselves can be stressful. What’s more, the physical challenges of infertility treatment tend to fall primarily on the woman.

Sperm are easy to analyze, but eggs are harder. Even when male factor infertility is to blame, fertility treatments may target the woman. For instance, a couple may choose in vitro fertilization when a man has low sperm motility. This requires a significant commitment from the woman.

Particularly when there’s inequality elsewhere in the relationship, this can trigger serious conflicts. A woman who feels like she spends more time learning about infertility or who does more cleaning than her partner, and who now must bear the physical burden of infertility treatment can quickly become resentful. Lack of support from her male partner may compound this resentment, exploding the relationship.

Even when a couple has great communication and is prepared to support each other through treatment, infertility treatments are challenging.

They may require:

Painful hormonal injections

Treatments that affect a woman’s body, emotions, and sleep

Abstaining from sex during certain periods of a monthly cycle

Invasive questions, tests, and exams. For people with a history of sexual abuse or a lot of body shame, this can be extremely painful and upsetting.

Infertility is a physical health issue. That means that treatment can trigger feelings of shame about body weight, physical health, lifestyle, and much more. For couples to get through it, they must support one another. This might mean picking up more slack at home, being ready to listen, or simply understanding that infertility treatment is challenging.

How Outside Pressures Make it Worse

“You two would be such great parents! When are you going to have a kid? You better give your parents some grandbabies soon!”

It’s an innocent question from a well-meaning (but nosy) bystander. For couples struggling with infertility, the message is clear: “You’re failing.”

Most people are able to get pregnant with little effort. The reminder of this fact from outsiders who assume you’re choosing not to have a baby can be enraging. It means infertile couples can never go very long without having to think about their infertility. That can make it difficult to enjoy family outings and reunions, or to sit back and relax during the holidays when Aunt Irma arrives with her questions about babies.

There’s something else afoot here: our culture makes it clear that having children is normal and expected. There’s a hidden assumption that people who don’t have children are selfish, or otherwise abnormal. That’s untrue, of course. People struggling with infertility face two forms of stigma: the stigma that people who choose not to have children face, and the stigma of infertility. Most people still choose not to openly discuss infertility. Which means in the general public's mind, infertility is rare -- and rarely discussed. The layers of assumptions surrounding this fact can build a painful prison of demands and dashed hopes.

When Your Approaches to Infertility Differ

Marriage is all about compromise. You have to decide how to spend your money, where to live, whether to have pets, where to spend the holidays, and so much more. Infertility throws an emotional bomb into your marriage, forcing you to make another series of decisions.

The odds are good that you’ll disagree about at least some of the following:

How long should we try before seeking treatment?

How hard should we try? Must we have sex every time there is a chance of pregnancy?

How long should we pursue infertility treatments?

Which infertility treatments should we try?

Should we make lifestyle changes? How extreme are the changes we are willing to make?

How much are we willing to spend on infertility treatment?

Is adoption an option? What about surrogacy?

How do we feel about donor eggs or donor sperm?

Can we have a happy marriage without children?

How do we assess an infertility doctor? What do we want most?

At what point will we try a different fertility clinic?

How much do we want to tell loved ones about our fertility struggles?

The Financial Realities of Infertility

Infertility treatment might not be as expensive as you think. Sometimes all it requires is treating an underlying medical condition. In some cases, that treatment might be covered by insurance.

Yet if simple treatments fail, an ugly reality lurks in the background: infertility is expensive. Most couples know this. Even before they know which treatments they need, many couples find themselves panicked about costs. The prospect of not having a child because you are not rich is unbelievably painful. It triggers issues of self-worth and resentment. It may also cause fights over how you spend your money.

Financial stress is a leading cause of divorce. Pair it with infertility and you have a recipe for intense pain.

Making Marriage Work When Infertility Rears its Ugly Head

There’s no getting around it: marriage is harder when you struggle with infertility. That doesn’t mean you can’t enjoy your life while you work to make a baby. It also doesn't mean that having a baby is the only way to be happy. Infertility presents a powerful opportunity to explore your assumptions about marriage, and to reshape your future. That process can be painful. But it will ultimately equip you with better communication skills that will serve you for the rest of your marriage.

Some simple strategies that can help you and your partner get through the pain include:

Talking openly about your feelings. Be direct, without blaming one another. Work together to provide support to one another. Discuss how you want to manage common challenges, such as whether and when to discuss your infertility with loved ones.

Seeking marriage counseling. Therapy can fortify your marriage and offer a safe space to discuss the challenges you face.

Joining an infertility support group. Knowing you’re not alone can work wonders.

Finding ways to enjoy one another that have nothing to do with infertility. Plan a weekly date night, even if you don’t feel up to it. Commit to a nightly walk or some other low-key time together. Take a class together. You’re all you have for now. Feed what you have while you prepare for what you want.

Selecting the right infertility clinic is also important. You deserve a doctor who gives you clear answers to difficult questions, a clinic with an excellent success rate, and a practice that will work with you to ensure that financial issues don’t thwart your dreams for your family.

Infertility is hard. The Center of Reproductive Medicine believes in making the journey easier. If you’re tired of trying, tired of fighting, and tired of wondering, it’s time to put science to work for you. Call us today!